T细胞斑点试验对活动性结核与非结核分枝杆菌感染的鉴别诊断价值

发布时间：2019-02-14 10:25

【摘要】：目的结核分枝杆菌(MTB)与非结核分枝杆菌(NTM)感染的鉴别较困难,本研究拟评估T细胞斑点试验(T-SPOT.TB)在活动性MTB与NTM感染的鉴别诊断价值。方法选取医院2013年1月-2017年2月各类标本分枝杆菌培养阳性并确诊为活动性感染患者176例,查找患者同期T细胞斑点试验结果,分别计算其对MTB与NTM感染的诊断灵敏度与特异度。结果活动性结核分枝杆菌感染114例,84例接受T-SPOT.TB试验,81例阳性,阳性率96.4%;非结核分枝杆菌感染62例,46例接受T-SPOT.TB试验,9例阳性,阳性率19.6%;T-SPOT.TB鉴别诊断灵敏度与特异度分别为96.4%、80.4%;肺部感染病例中,71例肺结核患者接受T-SPOT.TB试验,70例阳性,阳性率98.6%;40例非结核分枝杆菌肺病患者中,T-SPOT.TB阳性6例,阳性率15.0%,肺部感染患者中T-SPOT.TB灵敏度与特异度分别为98.6%、85.0%。结论 T细胞斑点试验对于MTB与NTM感染的灵敏度、特异度高,具有优良的临床鉴别诊断价值。
[Abstract]:Objective to evaluate the value of T cell spot test (T-SPOT.TB) in the differential diagnosis of active MTB and NTM infection. Methods from January 2013 to February 2017, 176 patients with positive mycobacterium culture and confirmed active infection were selected to find out the results of T cell spot test in the same period. Their sensitivity and specificity in the diagnosis of MTB and NTM infection were calculated. Results among 114 cases of active Mycobacterium tuberculosis infection, 84 cases received T-SPOT.TB test, 81 cases were positive, the positive rate was 96.4%. There were 62 cases of non-tuberculosis mycobacterium infection, 46 cases received T-SPOT.TB test, 9 cases were positive, the sensitivity and specificity of T-SPOT.TB differential diagnosis were 96.4% and 80.4%, respectively. T-SPOT.TB test was performed in 71 cases of pulmonary infection, 70 cases were positive, the positive rate was 98.66%. T-SPOT.TB was positive in 6 cases (15.0%), and the sensitivity and specificity of T-SPOT.TB in patients with pulmonary infection were 98.6% and 85.0%, respectively. Conclusion T cell dot test has high sensitivity and specificity in the diagnosis of MTB and NTM infection.
【作者单位】：复旦大学附属中山医院感染性疾病科;复旦大学附属中山医院感染管理科;
【基金】：复旦大学附属中山医院课题(2016ZSG-209) 上海市第四轮公共卫生三年行动计划重点学科《传染病与卫生微生物学》(15GWZK0101)
【分类号】：R446.6;R52

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